Skip to main content

Table 2 The strengths and weaknesses of various safety strategies of CAR-T cells

From: Next generation chimeric antigen receptor T cells: safety strategies to overcome toxicity

Safety strategy Strengths Weaknesses
Suicide switch HSV-TK 1. powerful effect
2. extensive clinical experience
1. immunogenicity
2. clinical incompatibility
3. slow onset
4. no preventive effect for toxicity
5. premature eradication of CAR-T cells
iCasp9 1. no immunogenicity
2.clinical compatibility
2. rapid onset
1. no preventive effect for toxicity
2. premature eradication of CAR-T cells
CD20 1. no immunogenicity
2. rapid onset
1. antibody biodistribution
2. on-target toxicity from antibody
3. prodrug infusion reaction
4. no preventive effect for toxicity
5. premature eradication of CAR-T cells
EGFRt 1. no immunogenicity
2. rapid onset
3. in vivo tracking
1. antibody biodistribution
2. on-target toxicity from antibody
3. prodrug infusion reaction
4. no preventive effect for toxicity 5. premature eradication of CAR-T cells
Endogenous switch synNotch 1. control the expression of the CARs
2. Specific recognition of tumor sites
1. uncontrolled activation of CAR-T cells 2. the choice of two antigens is difficult
iCAR 1. antigen-selectively regulate T cell responses
2. protect normal tissue from CAR-T cells
1. uncontrolled activation of CAR-T cells 2. potential “on-target, off-tumor” effect
Combinatorial Target-Antigen Recognition 1. precise killing of CAR-T cells
2. overcome antigen loss
1. uncontrolled activation of CAR-T cells
2. the choice of two antigens is difficult
3. potential “on-target, off-tumor” effect
Exogenous switch Bispecific T Cell Engager 1. controlled activation of CAR-T cells
2. simplify manufacturing of CAR-T cells
1. The choice of small molecules needs more consideration
On-switch CAR 1. controlled activation of CAR-T cells 1. The choice of small molecules needs more consideration